Abstract
We assessed the association between edentulism and all-cause mortality among community-dwelling older adults from São Paulo, Brazil, from 2006 to 2017. This prospective cohort study used data from the Health, Well-being and Aging Study (SABE, Portuguese acronym). Edentulism was evaluated by means of clinical oral examination and all-cause mortality data were obtained from state official records. Covariates included socioeconomic factors (age, sex, and schooling); health behavior (smoking, alcohol intake, and physical activity); dental care (prostheses use); general health (multimorbidity); and nutritional status (underweight). Kaplan-Meier survival curves were stratified by edentulism and compared using the log-rank test. Cox proportional hazards model was applied to calculate hazard ratios (HRs) for the association between edentulism and mortality after adjusting for covariates. The study sample included 1,687 participants (age, 60-102 years; edentulous: 47.2%). In the 11 years of follow-up, we analyzed 10,494 person-years and 566 deaths. In bivariate analysis, edentulous older adults were found to be at a higher risk of dying from all causes than the dentate participants (HR: 1.81; 95%CI: 1.53-2.15). After sequential adjustment for socioeconomic factors, health behavior, dental care, general health, and nutritional status, this association was attenuated, but remained significant (HR: 1.34; 95%CI: 1.10-1.63). In conclusion, edentulism is a significant predictor of all-cause mortality among older adults.
Highlights
Edentulism is an important oral health marker in older individuals,[1,2] as it captures life–course cumulative effects of oral diseases.[3]
Study design and participants All data were obtained from the Brazilian Health, Well–being and Aging Study (SABE), a multicenter survey conducted in major urban centers in Latin America in 2000
The unadjusted model demonstrated higher mortality risks from all causes for edentulous participants (HR: 1.81; 95%CI: 1.53–2.15) than for dentate participants (Table 2, model 1). These estimates became lower after sequential adjustment for socioeconomic factors (Table 2, model 2) and health behavior (Table 2, model 3)
Summary
Edentulism is an important oral health marker in older individuals,[1,2] as it captures life–course cumulative effects of oral diseases.[3].
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